Individual provider Active NPI

Andrea N Miller, APRN-CNP

  • Family Nurse Practitioner
  • Edmond, OK
National Provider Identifier
1073246393
Registry record updated Feb 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209679 Issued in OK
Practice address
2017 W I 35 Frontage Rd Ste 170
Edmond, OK 73013-8558
Phone
(405) 757-3742
Fax
(405) 757-3744
NPI assigned
Jul 5, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R0129629 OK
Family Nurse Practitioner 363LF0000X 209679 OK Primary

Addresses

Primary practice location

2017 W I 35 Frontage Rd Ste 170
Edmond, OK 73013-8558

Mailing address

2017 W I 35 Frontage Rd Ste 170
Edmond, OK 73013-8558
Phone (405) 757-3742

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230227001943 OK Practitioner - Nurse Practitioner 8224401070 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic Oklahoma CommunitiesGroup PAC ID 1153468921, 645 clinicians

Practice addresses (Care Compare)

2017 W I 35 Frontage Rd
Mercy Clinic
Edmond, OK 73013-8504
Phone (405) 757-3365

Hospital & facility affiliations

  • Mercy Home Health Home health agency, Oklahoma City, OK, CCN 377048
  • Mercy Hospital Oklahoma City, Inc Hospital, Oklahoma City, OK, CCN 370013
  • Mercy Hospital Logan County Hospital, Guthrie, OK, CCN 371317

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R0129629OKMDRegistered Nurse
209679OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Oklahoma Communities CurrentSince Jan 30, 2023 Accepting new patients
Summit Medical Center Past Accepting new patients
Mercy Hospital Oklahoma City, Inc PastSince Feb 19, 2023 Accepting new patients
Mercy Hospital Oklahoma City, Inc Past Accepting new patients

Locations

2017 W I 35 Frontage Rd
Edmond, OK 73013
Phone (405) 509-2800

2017 W I 35 Frontage Rd
Ste 170
Edmond, OK 73013
Phone (405) 757-3365

4300 McAuley Blvd
Oklahoma City, OK 73120
Phone (405) 936-5455

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1656979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676419200000",
    "number": "1073246393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2017 W I 35 FRONTAGE RD STE 170",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730138558",
            "telephone_number": "405-757-3742",
            "fax_number": "405-757-3744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2017 W I 35 FRONTAGE RD STE 170",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730138558",
            "telephone_number": "405-757-3742",
            "fax_number": "405-757-3744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "ANDREA",
        "middle_name": "N",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-05",
        "last_updated": "2023-02-15",
        "certification_date": "2023-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OK",
            "license": "R0129629",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "209679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

Verify at the official NPI Registry.